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Individual

DANNY GANTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
21935 VAN BUREN ST STE A1, GRAND TERRACE, CA 92313-5652
(909) 906-1023
Mailing address
21935 VAN BUREN ST STE A1, GRAND TERRACE, CA 92313-5652
(909) 906-1023

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
225400000X
Rehabilitation Practitioner
Primary

Other

Enumeration date
06/07/2023
Last updated
07/28/2023
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